{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:41:36Z","timestamp":1791834096266,"version":"4.3.4"},"reference-count":40,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Inj Prev"],"accepted":{"date-parts":[[2025,11,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Motor vehicle collisions (MVCs) are a leading cause of death for paediatric patients. Safety restraints are associated with improved outcomes. Prior work within our community identified decreased restraint use in patients treated in the city\u2019s urban core trauma centre. The present study expands prior work to include an additional paediatric trauma centre within our county.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was performed where the trauma registries of two level 1 trauma centres were queried for patients aged 0\u201318 from October 2013 to September 2023. Demographic and clinical outcomes were recorded. Appropriate restraint use was defined using the 2018 American Academy of Pediatrics restraint use guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>1028 paediatric MVCs were identified, averaging 112 MVC events annually. Overall, 54.6% of patients were inappropriately restrained, with the highest proportion in booster-sized patients (78% vs 50% seatbelt vs 57% car seat), p&lt;0.001. Those inappropriately restrained had higher Injury Severity Scores (ISSs) (17.6% vs 11.6% \u226515 ISS) and severe abbreviated injury scale scores for head, face, thorax and extremity. Inappropriate restraint use was associated with the need for surgical procedures (29.4% vs 18.4%), post-trauma complications (12.1% vs 4.5%) and mortality (3% vs 0.6%), all p&lt;0.01. Patients living in lower percentile Child Opportunity Index zip codes had higher odds of being inappropriately restrained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Appropriate restraint use remains low among paediatric patients in this metropolitan city. Inappropriate restraint use is most prominent in booster seat and seatbelt-aged populations with notable racial disparities. Interventions include hospital screenings, legislative advocacy and organisational partnerships.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/ip-2025-045803","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T11:35:22Z","timestamp":1765452922000},"page":"ip-2025-045803","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Paediatric motor vehicle collisions in an urban setting: assessing restraint use and socioeconomic disparities across trauma centres"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0032-2525","authenticated-orcid":false,"given":"Daniel M","family":"Alligood","sequence":"first","affiliation":[{"name":"Division of Pediatric Surgery, University of Miami, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D","family":"Pilarski","sequence":"additional","affiliation":[{"name":"Nicklaus Children\u2019s Hospital, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan V","family":"Laurendeau","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, University of Miami, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jake S","family":"Lesser","sequence":"additional","affiliation":[{"name":"Nicklaus Children\u2019s Hospital, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan B","family":"Creech","sequence":"additional","affiliation":[{"name":"Nicklaus Children\u2019s Hospital, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carly","family":"Davis","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, University of Miami, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mason M","family":"Flanagan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, University of Miami, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo A","family":"Perez","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, University of Miami, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan E","family":"Sola","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, University of Miami, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oneith O","family":"Cadiz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Miami, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricio E","family":"Lau","sequence":"additional","affiliation":[{"name":"Nicklaus Children\u2019s Hospital, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad M","family":"Thorson","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, University of Miami, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,12,11]]},"reference":[{"key":"2025121103351373000_ip-2025-045803v1.1","unstructured":"Centers for Disease Control and Prevention, National Center for Health Statistics . 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